Health Care

Hospitals With Quality-of-Care Problems Need Closer Monitoring Gao ID: HRD-91-40 May 9, 1991

Pursuant to a congressional request, GAO examined the adequacy of federal oversight of the Joint Commission on Accreditation of Healthcare Organizations' accreditation activities in hospitals serving Medicare patients.

GAO found that: (1) effective June 19, 1990, the Department of Health and Human Services (HHS) had access to data relating to Joint Commission surveys of hospitals serving Medicare patients, regardless of whether the Health Care Financing Administration (HCFA) conducted a survey; (2) once every 3 years, the Joint Commission surveyed hospitals that seek its accreditation; (3) HCFA considered hospitals that did not comply with one or more Medicare participation conditions to be susceptible to providing poor-quality care, and subject to termination from the Medicare program if compliance is not achieved within a specific period; (4) in nonaccredited hospitals, HCFA regional office review teams found that state agency surveys did not consistently identify Medicare conditions with which hospitals did not comply; and (5) to effectively assess the Commission's ability to identify hospitals that are not complying with Medicare requirements, HCFA must be able to establish a direct relationship between its conditions of participation and the Commission's standards.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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